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                    <h1>Begin Purchase</h1>
                    <p class="fs-20 opacity-70 mb-0">Follow the steps below to complete your MFG purchase, bookmark page to complete purchase later</p>
                    <a class="scroll-down-2 scroll-down-inverse" data-scrollto="stepone" href="https://tokensale.syncfab.com/purchase?i=14423#"><span></span></a>
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                        <p class="fs-60 fw-900 opacity-10">STEP 1</p>
                        <h3 class="fw-300">Copy our Deposit Address</h3>
                        <p>We are currently only accepting ETH for MFG. Copy our ETH deposit wallet address to the right and proceed to step 2.</p>
                        <p><strong>To learn how to convert BTC into ETH: <a target="_blank" href="https://medium.com/syncfabmfg/how-to-buy-mfg-tokens-with-bitcoin-btc-67212ed21b5f">Click Here</a><br>To learn how to convert Fiat into ETH: <a target="_blank" href="https://medium.com/syncfabmfg/converting-fiat-into-ethereum-b88a2726e2cf">Click Here</a></strong></p>
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                    <div class="col-sm-12 col-md-6 offset-md-1 aos-init aos-animate" data-aos="fade-up">
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                                <p class="fs-20 mb-10 fw-600" style="text-transform: uppercase;"><img width="40" src="./purchase/eth_icon.png"> Ethereum Wallet Address</p>
                                <div class="input-group mb-20" style="border-radius: 50px;">
                                    <input type="text" class="form-control fs-16 text-warning" value="0x34967C335d86EFc3043Fb75F807A0780Ffb6905A" id="ETHaddress" style="border-radius: 50px;">
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                    <button class="btn btn-xl btn-warning" style="border-radius: 0px 50px 50px 0px;" onclick="ETH()">Copy</button>
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                    <div class="col-12 col-md-5 text-center text-md-left">
                        <p class="fs-60 fw-900 opacity-10">STEP 2</p>
                        <h3 class="fw-300">Send Funds from Your Wallet</h3>
                        <p>You are allowed to use your preferred wallet (Coinbase, Gemini, Kraken, Exodus, Jaxx, etc.) to send funds to the deposit address listed above. We recommend using MyEtherWallet (ERC-20 Compatible).</p>
                        <p><strong>To learn how to create a MyEtherWallet: <a target="_blank" href="https://medium.com/syncfabmfg/how-to-create-an-ethereum-wallet-with-myetherwallet-612bc0cf49a9">Click here</a><br>To learn how to send ETH from MyEtherWallet: <a target="_blank" href="https://medium.com/syncfabmfg/how-to-buy-mfg-tokens-b5cd1c22f9de">Click here</a></strong></p>
                        <!--<p><strong>MFG Tokens will be distributed into your receiving wallet address (Entered on previous page) after our Main Token Sale event has concluded, we have reached our minimum goal and verify all participants through our KYC/AML process.</strong></p>-->
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                        <p class="fs-60 fw-900 opacity-10">Step 3</p>
                        <h3 class="fw-300">Verify Your Transaction</h3>
                        <p>After your transaction has been submitted, you will receive a Transaction Key (TX) that can be checked on <a target="_blank" href="https://etherscan.io/">Etherscan.io</a> to verify if your transaction was successful. The verification and status check will need some time to record on the Ethereum blockchain — please be patient.</p>
                        <p><strong>For step by step tutorial of this entire process: <a target="_blank" href="https://medium.com/syncfabmfg/how-to-buy-mfg-tokens-b5cd1c22f9de">Click Here</a></strong></p>
                        <p><strong><i>Please keep in mind that you will not receive MFG Tokens in your wallet after your contribution. MFG Tokens will be distributed into your receiving wallet address (Entered on previous page) after our Main Token Sale event has concluded, we have reached our minimum goal, and verify all participants through our KYC/AML process.</i></strong></p>
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                        <p class="fs-60 fw-900 opacity-10">STEP 4</p>
                        <h3 class="fw-300">Complete KYC Form</h3>
                        <p>SyncFab has implemented this verification step to stay legally compliant with KYC/AML (Know Your Customer/Anti-Money Laundering) regulations. This is an additional measure to ensure against accepting fraudulent contributions. The data submitted is automatically verified by <a href="https://www.identitymindglobal.com/" target="_blank">Identity Mind</a>, our security partner.</p>
                        <p><strong><i>All sale participants must complete KYC/AML form in order to receive their MFG tokens after our Main Sale has concluded.</i></strong></p>
                    </div>
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                        <div id="idm-container" class="idm-container"><img class="idm-spinner" src="./purchase/spinner.gif" id="init-spinner" style="display: none;">
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                                <section id="country-section" class="idm-row">
                                    <h3 id="country-section-title">Country Information</h3>
                                    <hr>
                                    <p id="country-section-header"></p>
                                    <div class="idm-row">
                                        <h4 id="country-label">Country</h4>
                                        <select id="country" name="country" class="crs-country idm-col-third" data-region-id="state" data-value="shortcode" required="" maxlength="2" data-blacklist="SY,KP,IR" data-crs-loaded="true">
                                            <option value="">Select country</option>
                                            <option value="AF">Afghanistan</option>
                                            <option value="AX">Åland Islands</option>
                                            <option value="AL">Albania</option>
                                            <option value="DZ">Algeria</option>
                                            <option value="AS">American Samoa</option>
                                            <option value="AD">Andorra</option>
                                            <option value="AO">Angola</option>
                                            <option value="AI">Anguilla</option>
                                            <option value="AQ">Antarctica</option>
                                            <option value="AG">Antigua and Barbuda</option>
                                            <option value="AR">Argentina</option>
                                            <option value="AM">Armenia</option>
                                            <option value="AW">Aruba</option>
                                            <option value="AU">Australia</option>
                                            <option value="AT">Austria</option>
                                            <option value="AZ">Azerbaijan</option>
                                            <option value="BS">Bahamas</option>
                                            <option value="BH">Bahrain</option>
                                            <option value="BD">Bangladesh</option>
                                            <option value="BB">Barbados</option>
                                            <option value="BY">Belarus</option>
                                            <option value="BE">Belgium</option>
                                            <option value="BZ">Belize</option>
                                            <option value="BJ">Benin</option>
                                            <option value="BM">Bermuda</option>
                                            <option value="BT">Bhutan</option>
                                            <option value="BO">Bolivia</option>
                                            <option value="BQ">Bonaire, Sint Eustatius and Saba</option>
                                            <option value="BA">Bosnia and Herzegovina</option>
                                            <option value="BW">Botswana</option>
                                            <option value="BV">Bouvet Island</option>
                                            <option value="BR">Brazil</option>
                                            <option value="IO">British Indian Ocean Territory</option>
                                            <option value="BN">Brunei Darussalam</option>
                                            <option value="BG">Bulgaria</option>
                                            <option value="BF">Burkina Faso</option>
                                            <option value="BI">Burundi</option>
                                            <option value="KH">Cambodia</option>
                                            <option value="CM">Cameroon</option>
                                            <option value="CA">Canada</option>
                                            <option value="CV">Cape Verde</option>
                                            <option value="KY">Cayman Islands</option>
                                            <option value="CF">Central African Republic</option>
                                            <option value="TD">Chad</option>
                                            <option value="CL">Chile</option>
                                            <option value="CN">China</option>
                                            <option value="CX">Christmas Island</option>
                                            <option value="CC">Cocos (Keeling) Islands</option>
                                            <option value="CO">Colombia</option>
                                            <option value="KM">Comoros</option>
                                            <option value="CG">Congo, Republic of the (Brazzaville)</option>
                                            <option value="CD">Congo, the Democratic Republic of the (Kinshasa)</option>
                                            <option value="CK">Cook Islands</option>
                                            <option value="CR">Costa Rica</option>
                                            <option value="CI">Côte d'Ivoire, Republic of</option>
                                            <option value="HR">Croatia</option>
                                            <option value="CU">Cuba</option>
                                            <option value="CW">Curaçao</option>
                                            <option value="CY">Cyprus</option>
                                            <option value="CZ">Czech Republic</option>
                                            <option value="DK">Denmark</option>
                                            <option value="DJ">Djibouti</option>
                                            <option value="DM">Dominica</option>
                                            <option value="DO">Dominican Republic</option>
                                            <option value="EC">Ecuador</option>
                                            <option value="EG">Egypt</option>
                                            <option value="SV">El Salvador</option>
                                            <option value="GQ">Equatorial Guinea</option>
                                            <option value="ER">Eritrea</option>
                                            <option value="EE">Estonia</option>
                                            <option value="ET">Ethiopia</option>
                                            <option value="FK">Falkland Islands (Islas Malvinas)</option>
                                            <option value="FO">Faroe Islands</option>
                                            <option value="FJ">Fiji</option>
                                            <option value="FI">Finland</option>
                                            <option value="FR">France</option>
                                            <option value="GF">French Guiana</option>
                                            <option value="PF">French Polynesia</option>
                                            <option value="TF">French Southern and Antarctic Lands</option>
                                            <option value="GA">Gabon</option>
                                            <option value="GM">Gambia, The</option>
                                            <option value="GE">Georgia</option>
                                            <option value="DE">Germany</option>
                                            <option value="GH">Ghana</option>
                                            <option value="GI">Gibraltar</option>
                                            <option value="GR">Greece</option>
                                            <option value="GL">Greenland</option>
                                            <option value="GD">Grenada</option>
                                            <option value="GP">Guadeloupe</option>
                                            <option value="GU">Guam</option>
                                            <option value="GT">Guatemala</option>
                                            <option value="GG">Guernsey</option>
                                            <option value="GN">Guinea</option>
                                            <option value="GW">Guinea-Bissau</option>
                                            <option value="GY">Guyana</option>
                                            <option value="HT">Haiti</option>
                                            <option value="HM">Heard Island and McDonald Islands</option>
                                            <option value="VA">Holy See (Vatican City)</option>
                                            <option value="HN">Honduras</option>
                                            <option value="HK">Hong Kong</option>
                                            <option value="HU">Hungary</option>
                                            <option value="IS">Iceland</option>
                                            <option value="IN">India</option>
                                            <option value="ID">Indonesia</option>
                                            <option value="IQ">Iraq</option>
                                            <option value="IE">Ireland</option>
                                            <option value="IM">Isle of Man</option>
                                            <option value="IL">Israel</option>
                                            <option value="IT">Italy</option>
                                            <option value="JM">Jamaica</option>
                                            <option value="JP">Japan</option>
                                            <option value="JE">Jersey</option>
                                            <option value="JO">Jordan</option>
                                            <option value="KZ">Kazakhstan</option>
                                            <option value="KE">Kenya</option>
                                            <option value="KI">Kiribati</option>
                                            <option value="KR">Korea, Republic of</option>
                                            <option value="KW">Kuwait</option>
                                            <option value="KG">Kyrgyzstan</option>
                                            <option value="LA">Laos</option>
                                            <option value="LV">Latvia</option>
                                            <option value="LB">Lebanon</option>
                                            <option value="LS">Lesotho</option>
                                            <option value="LR">Liberia</option>
                                            <option value="LY">Libya</option>
                                            <option value="LI">Liechtenstein</option>
                                            <option value="LT">Lithuania</option>
                                            <option value="LU">Luxembourg</option>
                                            <option value="MO">Macao</option>
                                            <option value="MK">Macedonia, Republic of</option>
                                            <option value="MG">Madagascar</option>
                                            <option value="MW">Malawi</option>
                                            <option value="MY">Malaysia</option>
                                            <option value="MV">Maldives</option>
                                            <option value="ML">Mali</option>
                                            <option value="MT">Malta</option>
                                            <option value="MH">Marshall Islands</option>
                                            <option value="MQ">Martinique</option>
                                            <option value="MR">Mauritania</option>
                                            <option value="MU">Mauritius</option>
                                            <option value="YT">Mayotte</option>
                                            <option value="MX">Mexico</option>
                                            <option value="FM">Micronesia, Federated States of</option>
                                            <option value="MD">Moldova</option>
                                            <option value="MC">Monaco</option>
                                            <option value="MN">Mongolia</option>
                                            <option value="ME">Montenegro</option>
                                            <option value="MS">Montserrat</option>
                                            <option value="MA">Morocco</option>
                                            <option value="MZ">Mozambique</option>
                                            <option value="MM">Myanmar</option>
                                            <option value="NA">Namibia</option>
                                            <option value="NR">Nauru</option>
                                            <option value="NP">Nepal</option>
                                            <option value="NL">Netherlands</option>
                                            <option value="NC">New Caledonia</option>
                                            <option value="NZ">New Zealand</option>
                                            <option value="NI">Nicaragua</option>
                                            <option value="NE">Niger</option>
                                            <option value="NG">Nigeria</option>
                                            <option value="NU">Niue</option>
                                            <option value="NF">Norfolk Island</option>
                                            <option value="MP">Northern Mariana Islands</option>
                                            <option value="NO">Norway</option>
                                            <option value="OM">Oman</option>
                                            <option value="PK">Pakistan</option>
                                            <option value="PW">Palau</option>
                                            <option value="PS">Palestine, State of</option>
                                            <option value="PA">Panama</option>
                                            <option value="PG">Papua New Guinea</option>
                                            <option value="PY">Paraguay</option>
                                            <option value="PE">Peru</option>
                                            <option value="PH">Philippines</option>
                                            <option value="PN">Pitcairn</option>
                                            <option value="PL">Poland</option>
                                            <option value="PT">Portugal</option>
                                            <option value="PR">Puerto Rico</option>
                                            <option value="QA">Qatar</option>
                                            <option value="RE">Réunion</option>
                                            <option value="RO">Romania</option>
                                            <option value="RU">Russian Federation</option>
                                            <option value="RW">Rwanda</option>
                                            <option value="BL">Saint Barthélemy</option>
                                            <option value="SH">Saint Helena, Ascension and Tristan da Cunha</option>
                                            <option value="KN">Saint Kitts and Nevis</option>
                                            <option value="LC">Saint Lucia</option>
                                            <option value="MF">Saint Martin</option>
                                            <option value="PM">Saint Pierre and Miquelon</option>
                                            <option value="VC">Saint Vincent and the Grenadines</option>
                                            <option value="WS">Samoa</option>
                                            <option value="SM">San Marino</option>
                                            <option value="ST">Sao Tome and Principe</option>
                                            <option value="SA">Saudi Arabia</option>
                                            <option value="SN">Senegal</option>
                                            <option value="RS">Serbia</option>
                                            <option value="SC">Seychelles</option>
                                            <option value="SL">Sierra Leone</option>
                                            <option value="SG">Singapore</option>
                                            <option value="SX">Sint Maarten (Dutch part)</option>
                                            <option value="SK">Slovakia</option>
                                            <option value="SI">Slovenia</option>
                                            <option value="SB">Solomon Islands</option>
                                            <option value="SO">Somalia</option>
                                            <option value="ZA">South Africa</option>
                                            <option value="GS">South Georgia and South Sandwich Islands</option>
                                            <option value="SS">South Sudan</option>
                                            <option value="ES">Spain</option>
                                            <option value="LK">Sri Lanka</option>
                                            <option value="SD">Sudan</option>
                                            <option value="SR">Suriname</option>
                                            <option value="SZ">Swaziland</option>
                                            <option value="SE">Sweden</option>
                                            <option value="CH">Switzerland</option>
                                            <option value="TW">Taiwan</option>
                                            <option value="TJ">Tajikistan</option>
                                            <option value="TZ">Tanzania, United Republic of</option>
                                            <option value="TH">Thailand</option>
                                            <option value="TL">Timor-Leste</option>
                                            <option value="TG">Togo</option>
                                            <option value="TK">Tokelau</option>
                                            <option value="TO">Tonga</option>
                                            <option value="TT">Trinidad and Tobago</option>
                                            <option value="TN">Tunisia</option>
                                            <option value="TR">Turkey</option>
                                            <option value="TM">Turkmenistan</option>
                                            <option value="TC">Turks and Caicos Islands</option>
                                            <option value="TV">Tuvalu</option>
                                            <option value="UG">Uganda</option>
                                            <option value="UA">Ukraine</option>
                                            <option value="AE">United Arab Emirates</option>
                                            <option value="GB">United Kingdom</option>
                                            <option value="US">United States</option>
                                            <option value="UM">United States Minor Outlying Islands</option>
                                            <option value="UY">Uruguay</option>
                                            <option value="UZ">Uzbekistan</option>
                                            <option value="VU">Vanuatu</option>
                                            <option value="VE">Venezuela, Bolivarian Republic of</option>
                                            <option value="VN">Vietnam</option>
                                            <option value="VG">Virgin Islands, British</option>
                                            <option value="VI">Virgin Islands, U.S.</option>
                                            <option value="WF">Wallis and Futuna</option>
                                            <option value="EH">Western Sahara</option>
                                            <option value="YE">Yemen</option>
                                            <option value="ZM">Zambia</option>
                                            <option value="ZW">Zimbabwe</option>
                                        </select>
                                        <span id="country_hidden" style="display:none;"></span></div>
                                    <p id="country-section-footer"></p>
                                </section>
                                <section id="personal-section" class="idm-row">
                                    <h3 id="personal-section-title">Personal Information</h3>
                                    <hr id="">
                                    <p id="personal-section-header"></p>
                                    <div class="idm-row form-group" id="">
                                        <h4 id="full-name-label">Full Name</h4>
                                        <input id="first_name" name="first_name" class="idm-col-third" placeholder="First Name" type="text" required="" pattern=".*[^ ].*" maxlength="14"><span id="first_name_hidden" style="display:none;" class="idm-inline"></span>
                                        <input id="middle_name" name="middle_name" required class="idm-col-third" placeholder="Middle Name" maxlength="14" pattern=".*[^ ].*" type="text"><span id="middle_name_hidden" style="display:none;" class="idm-inline"></span>
                                        <input id="last_name" name="last_name" class="idm-col-third" placeholder="Last Name" type="text" required="" pattern=".*[^ ].*" maxlength="50"><span id="last_name_hidden" style="display:none;"></span></div>
                                    <div class="idm-col-half" id="dob-container">
                                        <h4 id="dob-label">Date of Birth</h4>
                                        <select id="dob_day" name="dob_day" class="idm-col-third" required="">
                                            <option value="01">01</option>
                                            <option value="02">02</option>
                                            <option value="03">03</option>
                                            <option value="04">04</option>
                                            <option value="05">05</option>
                                            <option value="06">06</option>
                                            <option value="07">07</option>
                                            <option value="08">08</option>
                                            <option value="09">09</option>
                                            <option value="10">10</option>
                                            <option value="11">11</option>
                                            <option value="12">12</option>
                                            <option value="13">13</option>
                                            <option value="14">14</option>
                                            <option value="15">15</option>
                                            <option value="16">16</option>
                                            <option value="17">17</option>
                                            <option value="18">18</option>
                                            <option value="19">19</option>
                                            <option value="20">20</option>
                                            <option value="21">21</option>
                                            <option value="22">22</option>
                                            <option value="23">23</option>
                                            <option value="24">24</option>
                                            <option value="25">25</option>
                                            <option value="26">26</option>
                                            <option value="27">27</option>
                                            <option value="28">28</option>
                                            <option value="29">29</option>
                                            <option value="30">30</option>
                                            <option value="31">31</option>
                                        </select><span id="dob_day_hidden" style="display:none;" class="idm-inline"></span>
                                        <select id="dob_month" name="dob_month" class="idm-col-third" required="">
                                            <option value="01">January</option>
                                            <option value="02">February</option>
                                            <option value="03">March</option>
                                            <option value="04">April</option>
                                            <option value="05">May</option>
                                            <option value="06">June</option>
                                            <option value="07">July</option>
                                            <option value="08">August</option>
                                            <option value="09">September</option>
                                            <option value="10">October</option>
                                            <option value="11">November</option>
                                            <option value="12">December</option>
                                        </select><span id="dob_month_hidden" style="display:none;" class="idm-inline"></span>
                                        <select id="dob_year" name="dob_year" class="idm-col-third" required="">
                                            <option value="2012">2012</option>
                                            <option value="2011">2011</option>
                                            <option value="2010">2010</option>
                                            <option value="2009">2009</option>
                                            <option value="2008">2008</option>
                                            <option value="2007">2007</option>
                                            <option value="2006">2006</option>
                                            <option value="2005">2005</option>
                                            <option value="2004">2004</option>
                                            <option value="2003">2003</option>
                                            <option value="2002">2002</option>
                                            <option value="2001">2001</option>
                                            <option value="2000">2000</option>
                                            <option value="1999">1999</option>
                                            <option value="1998">1998</option>
                                            <option value="1997">1997</option>
                                            <option value="1996">1996</option>
                                            <option value="1995">1995</option>
                                            <option value="1994">1994</option>
                                            <option value="1993">1993</option>
                                            <option value="1992">1992</option>
                                            <option value="1991">1991</option>
                                            <option value="1990">1990</option>
                                            <option value="1989">1989</option>
                                            <option value="1988">1988</option>
                                            <option value="1987">1987</option>
                                            <option value="1986">1986</option>
                                            <option value="1985">1985</option>
                                            <option value="1984">1984</option>
                                            <option value="1983">1983</option>
                                            <option value="1982">1982</option>
                                            <option value="1981">1981</option>
                                            <option value="1980">1980</option>
                                            <option value="1979">1979</option>
                                            <option value="1978">1978</option>
                                            <option value="1977">1977</option>
                                            <option value="1976">1976</option>
                                            <option value="1975">1975</option>
                                            <option value="1974">1974</option>
                                            <option value="1973">1973</option>
                                            <option value="1972">1972</option>
                                            <option value="1971">1971</option>
                                            <option value="1970">1970</option>
                                            <option value="1969">1969</option>
                                            <option value="1968">1968</option>
                                            <option value="1967">1967</option>
                                            <option value="1966">1966</option>
                                            <option value="1965">1965</option>
                                            <option value="1964">1964</option>
                                            <option value="1963">1963</option>
                                            <option value="1962">1962</option>
                                            <option value="1961">1961</option>
                                            <option value="1960">1960</option>
                                            <option value="1959">1959</option>
                                            <option value="1958">1958</option>
                                            <option value="1957">1957</option>
                                            <option value="1956">1956</option>
                                            <option value="1955">1955</option>
                                            <option value="1954">1954</option>
                                            <option value="1953">1953</option>
                                            <option value="1952">1952</option>
                                            <option value="1951">1951</option>
                                            <option value="1950">1950</option>
                                            <option value="1949">1949</option>
                                            <option value="1948">1948</option>
                                            <option value="1947">1947</option>
                                            <option value="1946">1946</option>
                                            <option value="1945">1945</option>
                                            <option value="1944">1944</option>
                                            <option value="1943">1943</option>
                                            <option value="1942">1942</option>
                                            <option value="1941">1941</option>
                                            <option value="1940">1940</option>
                                            <option value="1939">1939</option>
                                            <option value="1938">1938</option>
                                            <option value="1937">1937</option>
                                            <option value="1936">1936</option>
                                            <option value="1935">1935</option>
                                            <option value="1934">1934</option>
                                            <option value="1933">1933</option>
                                            <option value="1932">1932</option>
                                            <option value="1931">1931</option>
                                            <option value="1930">1930</option>
                                            <option value="1929">1929</option>
                                            <option value="1928">1928</option>
                                            <option value="1927">1927</option>
                                            <option value="1926">1926</option>
                                            <option value="1925">1925</option>
                                            <option value="1924">1924</option>
                                            <option value="1923">1923</option>
                                            <option value="1922">1922</option>
                                            <option value="1921">1921</option>
                                            <option value="1920">1920</option>
                                            <option value="1919">1919</option>
                                            <option value="1918">1918</option>
                                            <option value="1917">1917</option>
                                            <option value="1916">1916</option>
                                            <option value="1915">1915</option>
                                            <option value="1914">1914</option>
                                            <option value="1913">1913</option>
                                            <option value="1912">1912</option>
                                            <option value="1911">1911</option>
                                            <option value="1910">1910</option>
                                            <option value="1909">1909</option>
                                            <option value="1908">1908</option>
                                            <option value="1907">1907</option>
                                            <option value="1906">1906</option>
                                            <option value="1905">1905</option>
                                            <option value="1904">1904</option>
                                            <option value="1903">1903</option>
                                            <option value="1902">1902</option>
                                            <option value="1901">1901</option>
                                            <option value="1900">1900</option>
                                        </select><span id="dob_year_hidden" style="display:none;"></span><small id="dob_error_message" style="color:red;"></small></div>
                                    <div class="idm-col-half form-group" style="display:none;" id="ssn-container">
                                        <h4 id="ssn-label">Social Security Number</h4>
                                        <input id="ssn" name="ssn" type="hidden" required=""><span id="ssn_hidden" style="display:none;"></span></div>
                                    <p id="personal-section-footer"></p>
                                    <input id="show_id_list" name="show_id_list" type="hidden" value="">
                                </section>
                                <section id="contact-section" class="idm-row form-group">
                                    <h3 id="contact-section-title">Contact Information</h3>
                                    <hr id="">
                                    <p id="contact-section-header"></p>
                                    <div class="idm-row" id="email-container">
                                        <h4 id="email-label">Email Address (Use same email as before)</h4>
                                        <input id="email" name="email" class="idm-col-third" type="email" required="" maxlength="60"><span id="email_hidden" style="display:none;"></span></div>
                                    <div class="idm-row" id="phone-container">
                                        <h4 id="phone-label">Phone Number</h4>
                                        <select name="phone_code" required="" class="idm-col-third">
                                            <option value="">Select Country Code</option>
                                            <option value="+93" data-code="AF">Afghanistan +93</option>
                                            <option value="+358" data-code="AX">Åland Islands +358</option>
                                            <option value="+355" data-code="AL">Albania +355</option>
                                            <option value="+213" data-code="DZ">Algeria +213</option>
                                            <option value="+1684" data-code="AS">American Samoa +1684</option>
                                            <option value="+376" data-code="AD">Andorra +376</option>
                                            <option value="+244" data-code="AO">Angola +244</option>
                                            <option value="+1264" data-code="AI">Anguilla +1264</option>
                                            <option value="+672" data-code="AQ">Antarctica +672</option>
                                            <option value="+1268" data-code="AG">Antigua and Barbuda +1268</option>
                                            <option value="+54" data-code="AR">Argentina +54</option>
                                            <option value="+374" data-code="AM">Armenia +374</option>
                                            <option value="+297" data-code="AW">Aruba +297</option>
                                            <option value="+61" data-code="AU">Australia +61</option>
                                            <option value="+43" data-code="AT">Austria +43</option>
                                            <option value="+994" data-code="AZ">Azerbaijan +994</option>
                                            <option value="+1242" data-code="BS">Bahamas +1242</option>
                                            <option value="+973" data-code="BH">Bahrain +973</option>
                                            <option value="+880" data-code="BD">Bangladesh +880</option>
                                            <option value="+1246" data-code="BB">Barbados +1246</option>
                                            <option value="+375" data-code="BY">Belarus +375</option>
                                            <option value="+32" data-code="BE">Belgium +32</option>
                                            <option value="+501" data-code="BZ">Belize +501</option>
                                            <option value="+229" data-code="BJ">Benin +229</option>
                                            <option value="+1441" data-code="BM">Bermuda +1441</option>
                                            <option value="+975" data-code="BT">Bhutan +975</option>
                                            <option value="+591" data-code="BO">Bolivia (Plurinational State of) +591</option>
                                            <option value="+5997" data-code="BQ">Bonaire, Sint Eustatius and Saba +5997</option>
                                            <option value="+387" data-code="BA">Bosnia and Herzegovina +387</option>
                                            <option value="+267" data-code="BW">Botswana +267</option>
                                            <option value="+47" data-code="BV">Bouvet Island +47</option>
                                            <option value="+55" data-code="BR">Brazil +55</option>
                                            <option value="+246" data-code="IO">British Indian Ocean Territory +246</option>
                                            <option value="+1" data-code="UM">United States Minor Outlying Islands +1</option>
                                            <option value="+1284" data-code="VG">Virgin Islands (British) +1284</option>
                                            <option value="+1" data-code="VI">Virgin Islands (U.S.) +1</option>
                                            <option value="+673" data-code="BN">Brunei Darussalam +673</option>
                                            <option value="+359" data-code="BG">Bulgaria +359</option>
                                            <option value="+226" data-code="BF">Burkina Faso +226</option>
                                            <option value="+257" data-code="BI">Burundi +257</option>
                                            <option value="+855" data-code="KH">Cambodia +855</option>
                                            <option value="+237" data-code="CM">Cameroon +237</option>
                                            <option value="+1" data-code="CA">Canada +1</option>
                                            <option value="+238" data-code="CV">Cabo Verde +238</option>
                                            <option value="+1345" data-code="KY">Cayman Islands +1345</option>
                                            <option value="+236" data-code="CF">Central African Republic +236</option>
                                            <option value="+235" data-code="TD">Chad +235</option>
                                            <option value="+56" data-code="CL">Chile +56</option>
                                            <option value="+86" data-code="CN">China +86</option>
                                            <option value="+61" data-code="CX">Christmas Island +61</option>
                                            <option value="+61" data-code="CC">Cocos (Keeling) Islands +61</option>
                                            <option value="+57" data-code="CO">Colombia +57</option>
                                            <option value="+269" data-code="KM">Comoros +269</option>
                                            <option value="+242" data-code="CG">Congo +242</option>
                                            <option value="+243" data-code="CD">Congo (Democratic Republic of the) +243</option>
                                            <option value="+682" data-code="CK">Cook Islands +682</option>
                                            <option value="+506" data-code="CR">Costa Rica +506</option>
                                            <option value="+385" data-code="HR">Croatia +385</option>
                                            <option value="+53" data-code="CU">Cuba +53</option>
                                            <option value="+599" data-code="CW">Curaçao +599</option>
                                            <option value="+357" data-code="CY">Cyprus +357</option>
                                            <option value="+420" data-code="CZ">Czech Republic +420</option>
                                            <option value="+45" data-code="DK">Denmark +45</option>
                                            <option value="+253" data-code="DJ">Djibouti +253</option>
                                            <option value="+1767" data-code="DM">Dominica +1767</option>
                                            <option value="+1809" data-code="DO">Dominican Republic +1809</option>
                                            <option value="+593" data-code="EC">Ecuador +593</option>
                                            <option value="+20" data-code="EG">Egypt +20</option>
                                            <option value="+503" data-code="SV">El Salvador +503</option>
                                            <option value="+240" data-code="GQ">Equatorial Guinea +240</option>
                                            <option value="+291" data-code="ER">Eritrea +291</option>
                                            <option value="+372" data-code="EE">Estonia +372</option>
                                            <option value="+251" data-code="ET">Ethiopia +251</option>
                                            <option value="+500" data-code="FK">Falkland Islands (Malvinas) +500</option>
                                            <option value="+298" data-code="FO">Faroe Islands +298</option>
                                            <option value="+679" data-code="FJ">Fiji +679</option>
                                            <option value="+358" data-code="FI">Finland +358</option>
                                            <option value="+33" data-code="FR">France +33</option>
                                            <option value="+594" data-code="GF">French Guiana +594</option>
                                            <option value="+689" data-code="PF">French Polynesia +689</option>
                                            <option value="+262" data-code="TF">French Southern Territories +262</option>
                                            <option value="+241" data-code="GA">Gabon +241</option>
                                            <option value="+220" data-code="GM">Gambia +220</option>
                                            <option value="+995" data-code="GE">Georgia +995</option>
                                            <option value="+49" data-code="DE">Germany +49</option>
                                            <option value="+233" data-code="GH">Ghana +233</option>
                                            <option value="+350" data-code="GI">Gibraltar +350</option>
                                            <option value="+30" data-code="GR">Greece +30</option>
                                            <option value="+299" data-code="GL">Greenland +299</option>
                                            <option value="+1473" data-code="GD">Grenada +1473</option>
                                            <option value="+590" data-code="GP">Guadeloupe +590</option>
                                            <option value="+1671" data-code="GU">Guam +1671</option>
                                            <option value="+502" data-code="GT">Guatemala +502</option>
                                            <option value="+44" data-code="GG">Guernsey +44</option>
                                            <option value="+224" data-code="GN">Guinea +224</option>
                                            <option value="+245" data-code="GW">Guinea-Bissau +245</option>
                                            <option value="+592" data-code="GY">Guyana +592</option>
                                            <option value="+509" data-code="HT">Haiti +509</option>
                                            <option value="+0" data-code="HM">Heard Island and McDonald Islands +0</option>
                                            <option value="+379" data-code="VA">Holy See +379</option>
                                            <option value="+504" data-code="HN">Honduras +504</option>
                                            <option value="+852" data-code="HK">Hong Kong +852</option>
                                            <option value="+36" data-code="HU">Hungary +36</option>
                                            <option value="+354" data-code="IS">Iceland +354</option>
                                            <option value="+91" data-code="IN">India +91</option>
                                            <option value="+62" data-code="ID">Indonesia +62</option>
                                            <option value="+225" data-code="CI">Côte d'Ivoire +225</option>
                                            <option value="+98" data-code="IR">Iran (Islamic Republic of) +98</option>
                                            <option value="+964" data-code="IQ">Iraq +964</option>
                                            <option value="+353" data-code="IE">Ireland +353</option>
                                            <option value="+44" data-code="IM">Isle of Man +44</option>
                                            <option value="+972" data-code="IL">Israel +972</option>
                                            <option value="+39" data-code="IT">Italy +39</option>
                                            <option value="+1876" data-code="JM">Jamaica +1876</option>
                                            <option value="+81" data-code="JP">Japan +81</option>
                                            <option value="+44" data-code="JE">Jersey +44</option>
                                            <option value="+962" data-code="JO">Jordan +962</option>
                                            <option value="+76" data-code="KZ">Kazakhstan +76</option>
                                            <option value="+254" data-code="KE">Kenya +254</option>
                                            <option value="+686" data-code="KI">Kiribati +686</option>
                                            <option value="+965" data-code="KW">Kuwait +965</option>
                                            <option value="+996" data-code="KG">Kyrgyzstan +996</option>
                                            <option value="+856" data-code="LA">Lao People's Democratic Republic +856</option>
                                            <option value="+371" data-code="LV">Latvia +371</option>
                                            <option value="+961" data-code="LB">Lebanon +961</option>
                                            <option value="+266" data-code="LS">Lesotho +266</option>
                                            <option value="+231" data-code="LR">Liberia +231</option>
                                            <option value="+218" data-code="LY">Libya +218</option>
                                            <option value="+423" data-code="LI">Liechtenstein +423</option>
                                            <option value="+370" data-code="LT">Lithuania +370</option>
                                            <option value="+352" data-code="LU">Luxembourg +352</option>
                                            <option value="+853" data-code="MO">Macao +853</option>
                                            <option value="+389" data-code="MK">Macedonia (the former Yugoslav Republic of) +389</option>
                                            <option value="+261" data-code="MG">Madagascar +261</option>
                                            <option value="+265" data-code="MW">Malawi +265</option>
                                            <option value="+60" data-code="MY">Malaysia +60</option>
                                            <option value="+960" data-code="MV">Maldives +960</option>
                                            <option value="+223" data-code="ML">Mali +223</option>
                                            <option value="+356" data-code="MT">Malta +356</option>
                                            <option value="+692" data-code="MH">Marshall Islands +692</option>
                                            <option value="+596" data-code="MQ">Martinique +596</option>
                                            <option value="+222" data-code="MR">Mauritania +222</option>
                                            <option value="+230" data-code="MU">Mauritius +230</option>
                                            <option value="+262" data-code="YT">Mayotte +262</option>
                                            <option value="+52" data-code="MX">Mexico +52</option>
                                            <option value="+691" data-code="FM">Micronesia (Federated States of) +691</option>
                                            <option value="+373" data-code="MD">Moldova (Republic of) +373</option>
                                            <option value="+377" data-code="MC">Monaco +377</option>
                                            <option value="+976" data-code="MN">Mongolia +976</option>
                                            <option value="+382" data-code="ME">Montenegro +382</option>
                                            <option value="+1664" data-code="MS">Montserrat +1664</option>
                                            <option value="+212" data-code="MA">Morocco +212</option>
                                            <option value="+258" data-code="MZ">Mozambique +258</option>
                                            <option value="+95" data-code="MM">Myanmar +95</option>
                                            <option value="+264" data-code="NA">Namibia +264</option>
                                            <option value="+674" data-code="NR">Nauru +674</option>
                                            <option value="+977" data-code="NP">Nepal +977</option>
                                            <option value="+31" data-code="NL">Netherlands +31</option>
                                            <option value="+687" data-code="NC">New Caledonia +687</option>
                                            <option value="+64" data-code="NZ">New Zealand +64</option>
                                            <option value="+505" data-code="NI">Nicaragua +505</option>
                                            <option value="+227" data-code="NE">Niger +227</option>
                                            <option value="+234" data-code="NG">Nigeria +234</option>
                                            <option value="+683" data-code="NU">Niue +683</option>
                                            <option value="+672" data-code="NF">Norfolk Island +672</option>
                                            <option value="+850" data-code="KP">Korea (Democratic People's Republic of) +850</option>
                                            <option value="+1670" data-code="MP">Northern Mariana Islands +1670</option>
                                            <option value="+47" data-code="NO">Norway +47</option>
                                            <option value="+968" data-code="OM">Oman +968</option>
                                            <option value="+92" data-code="PK">Pakistan +92</option>
                                            <option value="+680" data-code="PW">Palau +680</option>
                                            <option value="+970" data-code="PS">Palestine, State of +970</option>
                                            <option value="+507" data-code="PA">Panama +507</option>
                                            <option value="+675" data-code="PG">Papua New Guinea +675</option>
                                            <option value="+595" data-code="PY">Paraguay +595</option>
                                            <option value="+51" data-code="PE">Peru +51</option>
                                            <option value="+63" data-code="PH">Philippines +63</option>
                                            <option value="+64" data-code="PN">Pitcairn +64</option>
                                            <option value="+48" data-code="PL">Poland +48</option>
                                            <option value="+351" data-code="PT">Portugal +351</option>
                                            <option value="+1787" data-code="PR">Puerto Rico +1787</option>
                                            <option value="+974" data-code="QA">Qatar +974</option>
                                            <option value="+383" data-code="XK">Republic of Kosovo +383</option>
                                            <option value="+262" data-code="RE">Réunion +262</option>
                                            <option value="+40" data-code="RO">Romania +40</option>
                                            <option value="+7" data-code="RU">Russian Federation +7</option>
                                            <option value="+250" data-code="RW">Rwanda +250</option>
                                            <option value="+590" data-code="BL">Saint Barthélemy +590</option>
                                            <option value="+290" data-code="SH">Saint Helena, Ascension and Tristan da Cunha +290</option>
                                            <option value="+1869" data-code="KN">Saint Kitts and Nevis +1869</option>
                                            <option value="+1758" data-code="LC">Saint Lucia +1758</option>
                                            <option value="+590" data-code="MF">Saint Martin (French part) +590</option>
                                            <option value="+508" data-code="PM">Saint Pierre and Miquelon +508</option>
                                            <option value="+1784" data-code="VC">Saint Vincent and the Grenadines +1784</option>
                                            <option value="+685" data-code="WS">Samoa +685</option>
                                            <option value="+378" data-code="SM">San Marino +378</option>
                                            <option value="+239" data-code="ST">Sao Tome and Principe +239</option>
                                            <option value="+966" data-code="SA">Saudi Arabia +966</option>
                                            <option value="+221" data-code="SN">Senegal +221</option>
                                            <option value="+381" data-code="RS">Serbia +381</option>
                                            <option value="+248" data-code="SC">Seychelles +248</option>
                                            <option value="+232" data-code="SL">Sierra Leone +232</option>
                                            <option value="+65" data-code="SG">Singapore +65</option>
                                            <option value="+1721" data-code="SX">Sint Maarten (Dutch part) +1721</option>
                                            <option value="+421" data-code="SK">Slovakia +421</option>
                                            <option value="+386" data-code="SI">Slovenia +386</option>
                                            <option value="+677" data-code="SB">Solomon Islands +677</option>
                                            <option value="+252" data-code="SO">Somalia +252</option>
                                            <option value="+27" data-code="ZA">South Africa +27</option>
                                            <option value="+500" data-code="GS">South Georgia and the South Sandwich Islands +500</option>
                                            <option value="+82" data-code="KR">Korea (Republic of) +82</option>
                                            <option value="+211" data-code="SS">South Sudan +211</option>
                                            <option value="+34" data-code="ES">Spain +34</option>
                                            <option value="+94" data-code="LK">Sri Lanka +94</option>
                                            <option value="+249" data-code="SD">Sudan +249</option>
                                            <option value="+597" data-code="SR">Suriname +597</option>
                                            <option value="+4779" data-code="SJ">Svalbard and Jan Mayen +4779</option>
                                            <option value="+268" data-code="SZ">Swaziland +268</option>
                                            <option value="+46" data-code="SE">Sweden +46</option>
                                            <option value="+41" data-code="CH">Switzerland +41</option>
                                            <option value="+963" data-code="SY">Syrian Arab Republic +963</option>
                                            <option value="+886" data-code="TW">Taiwan +886</option>
                                            <option value="+992" data-code="TJ">Tajikistan +992</option>
                                            <option value="+255" data-code="TZ">Tanzania, United Republic of +255</option>
                                            <option value="+66" data-code="TH">Thailand +66</option>
                                            <option value="+670" data-code="TL">Timor-Leste +670</option>
                                            <option value="+228" data-code="TG">Togo +228</option>
                                            <option value="+690" data-code="TK">Tokelau +690</option>
                                            <option value="+676" data-code="TO">Tonga +676</option>
                                            <option value="+1868" data-code="TT">Trinidad and Tobago +1868</option>
                                            <option value="+216" data-code="TN">Tunisia +216</option>
                                            <option value="+90" data-code="TR">Turkey +90</option>
                                            <option value="+993" data-code="TM">Turkmenistan +993</option>
                                            <option value="+1649" data-code="TC">Turks and Caicos Islands +1649</option>
                                            <option value="+688" data-code="TV">Tuvalu +688</option>
                                            <option value="+256" data-code="UG">Uganda +256</option>
                                            <option value="+380" data-code="UA">Ukraine +380</option>
                                            <option value="+971" data-code="AE">United Arab Emirates +971</option>
                                            <option value="+44" data-code="GB">United Kingdom of Great Britain and Northern Ireland +44</option>
                                            <option value="+1" data-code="US">United States of America +1</option>
                                            <option value="+598" data-code="UY">Uruguay +598</option>
                                            <option value="+998" data-code="UZ">Uzbekistan +998</option>
                                            <option value="+678" data-code="VU">Vanuatu +678</option>
                                            <option value="+58" data-code="VE">Venezuela (Bolivarian Republic of) +58</option>
                                            <option value="+84" data-code="VN">Viet Nam +84</option>
                                            <option value="+681" data-code="WF">Wallis and Futuna +681</option>
                                            <option value="+212" data-code="EH">Western Sahara +212</option>
                                            <option value="+967" data-code="YE">Yemen +967</option>
                                            <option value="+260" data-code="ZM">Zambia +260</option>
                                            <option value="+263" data-code="ZW">Zimbabwe +263</option>
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